Wayward & Wild Collective, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WAYWARD & WILD COLLECTIVE, LLC

Practice address

1101 Reading Ave Lowr
Boyertown, PA 19512-7549

Phone

(484) 300-8290

NPI assigned

Sep 16, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon Colgan, LPCNPI 1558079061

Title

Director

Phone

(484) 300-8290

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon F Colgan, LPC

  • Mental Health Counselor
  • Boyertown, PA
  • NPI 1558079061
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1003727033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 READING AVE LOWR",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195127549",
            "telephone_number": "484-300-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 READING AVE LOWR",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195127549",
            "telephone_number": "484-300-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYWARD & WILD COLLECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "COLGAN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "484-300-8290",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Magic Speech Bus LLC
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• Terry L Tomkins Hudon, RPH
• Twin Rivers Podiatry of Boyertown
• Jay A. Valenci, DMD
• Patricia Jane Weiser, PHARMD
• Lisa Ann Weller, M.A., LAPC, LBS
• Candice Widuch-Mert, MD
• Carl Jason Wiedlich, MSPT
• William J. Lien, M.D., P.C. (Boyertown Family Medicine)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Boyertown, PA
• Providers in Boyertown, PA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.